Aging doesn't just affect your joints and skin. Your vision is also at risk. Here's what you need to know about cataracts, presbyopia, glaucoma, and age-related macular degeneration.
By Katherine Lee
Medically reviewed by Lindsey Marcellin, MD, MPH
It’s an inevitable fact of life: Your eyes change as you get older. For one thing, your risk of eye diseases such as macular degeneration increases with age. And, as those in their forties can tell you, reading and seeing things up close becomes a problem because of a condition called presbyopia.
Here’s an overview of how your eyes change with age and what you can do to help your eyes stay healthy.
Aging: How Vision Is Affected
Presbyopia is the most common effect of age on vision. “As we age, the lens of the eye becomes less flexible,” says James Salz, a clinical professor of ophthalmology at the University of Southern California in Los Angeles and a spokesperson for the American Academy of Ophthalmologists. When the eye lens becomes more rigid, people have trouble focusing on close objects.
The following are some other ways in which aging can affect vision:
Lighting. As our eyes age, we need more light to see well, especially when we read or do other close-range tasks.
Glare. Age-related changes to the lens cause light entering the eye to be scattered instead of focused mostly on the retina — the light-sensing layer of cells at the back of the eye — producing glare and adding to vision problems.
Colors. The lenses in your eyes can become discolored — for example, by cataracts — making it more difficult to distinguish colors.
Tear production. The tear glands in the eyes make fewer tears with age, leading to dry, irritated eyes, particularly among postmenopausal women.
Vision Problems in Older Eyes
Age also increases your risk for eye diseases. In people age 40 and over, age-related macular degeneration (AMD), glaucoma, and cataracts are the most common eye problems.
Age-related macular degeneration. Macular degeneration, which affects the part of the retina crucial for sharp and clear vision, is the leading cause of blindness in Caucasian people over age 65.
Glaucoma. Glaucoma is actually a group of eye diseases that affect pressure inside the eye. Increased pressure affects the optic nerve, which carries images to the brain. People over age 60 are at increased risk for glaucoma.
Cataracts. A cataract is a clouding of the eye, commonly caused by aging. In age-related cataracts, the center of the lens gradually becomes hard and cloudy; it eventually becomes difficult for a person to see things at a distance and even to distinguish colors.
Symptoms and Warning Signs
Some age-related eye diseases, such as glaucoma and age-related macular degeneration, may cause few or no symptoms until the disease is at an advanced stage. For this reason, it’s important to see a doctor if you notice any of the following symptoms:
Double vision in one eye, a possible symptom of cataracts
Reduced ability to see at night, a possible symptom of cataracts
Colors appearing faded or tinted with yellow, a possible symptom of cataracts
Sensitivity to light or glare, a possible symptom of cataracts
Distorted vision that makes straight lines look blurred or results in a blind spot appearing in the center of your vision, a possible symptom of macular degeneration
Blurry vision, a symptom of a number of potential eye problems, such as cataracts, glaucoma, macular degeneration, and, in diabetics, a condition known as diabetic retinopathy
Any fluctuations in vision, a possible sign of a systemic disorder such as diabetes or high blood pressure
Appearance of floaters or flashes; occasional floaters are normal, but if you see a noticeable increase in floaters, especially if accompanied by flashes of light, you could be at risk for retinal detachment, which requires immediate treatment to prevent blindness
Eye pain, a possible symptom of glaucoma
Caring for Aging Eyes
Annual eye exams for anyone age 65 and older are essential for preventing and getting early treatment for eye diseases.
Also, the following tips can help you protect aging eyes:
Take supplements with lutein, which can help reduce the risk of chronic eye disorders
Always wear sunglasses outdoors to help prevent cataracts and macular degeneration
Eat a nutritious diet that includes dark, leafy green vegetables and orange foods such as carrots, which contain lutein
While presbyopia and increased risk for macular degeneration and other eye conditions are an inevitable part of aging, you can take steps — no matter what your age — to ensure that your eyes stay healthy.
Last Updated: 01/20/2010
This section created and produced exclusively by the editorial staff of EverydayHealth.com. © 2010 EverydayHealth.com; all rights reserved.
Verlia Caldwell, Pres.
Visit us at http://www.icareforyouhomecare.com if you need home care in Charlotte, N.C..
I Care For You Home Care, L.L.C.
1(800) 383-0520
Tuesday, April 13, 2010
Monday, April 5, 2010
Sense of Home Important Is in Residential Care for the Elderly
ScienceDaily (Apr. 4, 2010) — Many elderly people in residential care feel insecure during relocation or renovation work -- but there are ways of handling the situation. Those who manage to create a sense of home where they live are in a better position to cope with the stresses that go with change, reveals a thesis from the Sahlgrenska Academy.
Going into residential care means that elderly people have to adapt to an environment that differs in many ways to what they are used to.
"A sense of belonging where you live is important for your sense of self and identity, which, in turn, strengthens a person's ability to deal with the changes that impaired function and institutionalisation can bring," says Hanna Falk, nurse and doctoral student at the Institute of Health and Care Sciences.
The thesis also examines how the elderly define the concept of "a sense of home," and found that it covers far more than just a pleasant physical environment.
"There are other factors that come into play, for example that the elderly furnish their rooms exactly as they did when they lived at home, or that they make new friends who contribute to a greater sense of home," says Falk, stating that actual attachment to the institution is vital if it is to be viewed as home.
She also found that renovations designed to help create a more home-like and supportive environment in residential care have little impact on how the elderly perceive the atmosphere. Furthermore, relocation and renovations -- and the problems that they bring -- can negatively affect the quality of life and wellbeing of the elderly.
"The vulnerability of the elderly in connection with changes to their environment must be given greater consideration in the context of extensive renovations than is currently the case in the care of the elderly," says Falk. "There's still plenty of work to be done, for example the development of action plans to handle relocations and renovations so that the elderly and the staff are in the best possible position to cope with the situation."
Verlia Caldwell, Pres.
Visit us at http://www.icareforyouhomecare.com if you need home care in Charlotte, N.C..
I Care For You Home Care, L.L.C.
1(800) 383-0520
Going into residential care means that elderly people have to adapt to an environment that differs in many ways to what they are used to.
"A sense of belonging where you live is important for your sense of self and identity, which, in turn, strengthens a person's ability to deal with the changes that impaired function and institutionalisation can bring," says Hanna Falk, nurse and doctoral student at the Institute of Health and Care Sciences.
The thesis also examines how the elderly define the concept of "a sense of home," and found that it covers far more than just a pleasant physical environment.
"There are other factors that come into play, for example that the elderly furnish their rooms exactly as they did when they lived at home, or that they make new friends who contribute to a greater sense of home," says Falk, stating that actual attachment to the institution is vital if it is to be viewed as home.
She also found that renovations designed to help create a more home-like and supportive environment in residential care have little impact on how the elderly perceive the atmosphere. Furthermore, relocation and renovations -- and the problems that they bring -- can negatively affect the quality of life and wellbeing of the elderly.
"The vulnerability of the elderly in connection with changes to their environment must be given greater consideration in the context of extensive renovations than is currently the case in the care of the elderly," says Falk. "There's still plenty of work to be done, for example the development of action plans to handle relocations and renovations so that the elderly and the staff are in the best possible position to cope with the situation."
Verlia Caldwell, Pres.
Visit us at http://www.icareforyouhomecare.com if you need home care in Charlotte, N.C..
I Care For You Home Care, L.L.C.
1(800) 383-0520
Wednesday, March 24, 2010
Men and Women Respond Differently to Stress
ScienceDaily (Mar. 23, 2010) — Age and gender play a major role in how people respond to stress, according to a new study on 20-to-64-year-olds. Published in the journal Psychophysiology, the investigation was led by scientists from the Université de Montréal and the Montreal Heart Institute in collaboration with colleagues from the Université du Québec à Montréal and McGill University.
"Our findings suggest that women who are more defensive are at increased cardiovascular risk, whereas low defensiveness appears to damage the health of older men," says Bianca D'Antono, a professor at the Université de Montréal Department of Psychiatry and a Montreal Heart Institute researcher.
Defensiveness is a trait characterized by avoidance, denial or repression of information perceived as threatening. In women, a strong defensive reaction to judgment from others or a threat to self-esteem will result in high blood pressure and heart rate. Contrarily, older men with low defensive reactions have a higher cardiovascular rates.
The study was conducted on 81 healthy working men and 118 women. According to Dr. Jean-Claude Tardif a Université de Montréal professor and Montreal Heart Institute researcher, the physiological response to stress in women and older men is linked to this desire of maintaining self-esteem and securing social bonds.
"The sense of belonging is a basic human need," says D'Antono. "Our findings suggest that socialization is innate and that belonging to a group contributed to the survival of our ancestors. Today, it is possible that most people view social exclusion as a threat to their existence. A strong defensive reaction is useful to maintain one's self-esteem faced with this potential threat."
As part of the experiment, participants completed four tasks of varying stress levels. The first task involved reading a neutral text on Antarctica's geography before a person of the same sex. The second and third tasks involved role-playing in which participants followed a script where they were sometimes agreeable and sometimes aggressive. The final task involved a non-scripted debate on abortion.
Heart rate and blood pressure were measured during each of these tasks as was the level of cortisol in saliva. Results showed that women and older men had elevated cardiovascular, autonomic and endocrine responses to stress -- all potentially damaging to their health. The research team cautions, however, that more studies are needed to evaluate the long-term effects of defensiveness and its association to stress response patterns in disease development.
This study was supported by the Canadian Institutes of Health Research and the Fonds de la recherche en santé du Québec.
:
Story Source:
Adapted from materials provided by University of Montreal.
Verlia Caldwell, Pres.
Visit us at http://www.icareforyouhomecare.com if you need home care in Charlotte, N.C..
I Care For You Home Care, L.L.C.
1(800) 383-0520
"Our findings suggest that women who are more defensive are at increased cardiovascular risk, whereas low defensiveness appears to damage the health of older men," says Bianca D'Antono, a professor at the Université de Montréal Department of Psychiatry and a Montreal Heart Institute researcher.
Defensiveness is a trait characterized by avoidance, denial or repression of information perceived as threatening. In women, a strong defensive reaction to judgment from others or a threat to self-esteem will result in high blood pressure and heart rate. Contrarily, older men with low defensive reactions have a higher cardiovascular rates.
The study was conducted on 81 healthy working men and 118 women. According to Dr. Jean-Claude Tardif a Université de Montréal professor and Montreal Heart Institute researcher, the physiological response to stress in women and older men is linked to this desire of maintaining self-esteem and securing social bonds.
"The sense of belonging is a basic human need," says D'Antono. "Our findings suggest that socialization is innate and that belonging to a group contributed to the survival of our ancestors. Today, it is possible that most people view social exclusion as a threat to their existence. A strong defensive reaction is useful to maintain one's self-esteem faced with this potential threat."
As part of the experiment, participants completed four tasks of varying stress levels. The first task involved reading a neutral text on Antarctica's geography before a person of the same sex. The second and third tasks involved role-playing in which participants followed a script where they were sometimes agreeable and sometimes aggressive. The final task involved a non-scripted debate on abortion.
Heart rate and blood pressure were measured during each of these tasks as was the level of cortisol in saliva. Results showed that women and older men had elevated cardiovascular, autonomic and endocrine responses to stress -- all potentially damaging to their health. The research team cautions, however, that more studies are needed to evaluate the long-term effects of defensiveness and its association to stress response patterns in disease development.
This study was supported by the Canadian Institutes of Health Research and the Fonds de la recherche en santé du Québec.
:
Story Source:
Adapted from materials provided by University of Montreal.
Verlia Caldwell, Pres.
Visit us at http://www.icareforyouhomecare.com if you need home care in Charlotte, N.C..
I Care For You Home Care, L.L.C.
1(800) 383-0520
Friday, March 19, 2010
Cat Care: Pets for Senior Citizens by the American Animal Hospital Association
You've probably noticed that when you pet a soft, warm cat or play fetch with a dog whose tail won't stop wagging, you relax and your heart feels a little warmer.
Scientists have noticed the same thing, and they've started to explore the complex way animals affect human emotions and physiology. The resulting studies have shown that owning and handling animals significantly benefits health, and not just for the young. In fact, pets may help elderly owners live longer, healthier, and more enjoyable lives.
A study published in the Journal of the American Geriatrics Society in May of 1999 demonstrated that independently living seniors that have pets tend to have better physical health and mental wellbeing than those that don't. They're more active, cope better with stress, and have better overall health. A 1997 study showed that elderly pet owners had significantly lower blood pressure overall than their contemporaries without pets. In fact, an experimental residential home for the elderly called the Eden Alternative, which is filled with over 100 birds, dogs, and cats and has an outside environment with rabbits and chickens, has experienced a 15 percent lower mortality rate than traditional nursing homes over the past five years.
How do they do it?
There are a number of explanations for exactly how pets accomplish all these health benefits. First of all, pets need walking, feeding, grooming, fresh water, and fresh kitty litter, and they encourage lots of playing and petting. All of these activities require some action from owners. Even if it's just getting up to let a dog out a few times a day or brushing a cat, any activity can benefit the cardiovascular system and help keep joints limber and flexible. Consistently performing this kind of minor exercise can keep pet owners able to carry out the normal activities of daily living. Pets may also aid seniors simply by providing some physical contact. Studies have shown that when people pet animals, their blood pressure, heart rate, and temperature decrease.
Many benefits of pet ownership are less tangible, though. Pets are an excellent source of companionship, for example. They can act as a support system for older people who don't have any family or close friends nearby to act as a support system. The JAGS study showed that people with pets were better able to remain emotionally stable during crises than those without. Pets can also work as a buffer against social isolation. Often the elderly have trouble leaving home, so they don't have a chance to see many people. Pets give them a chance to interact. This can help combat depression, one of the most common medical problems facing seniors today. The responsibility of caring for an animal may also give the elderly a sense of purpose, a reason to get up in the morning. Pets also help seniors stick to regular routines of getting up in the morning, buying groceries, and going outside, which help motivate them to eat and sleep regularly and well.
Pets in residence
Many nursing homes have taken this information to heart. For years, organizations like Pets on Wheels and Therapy Dogs International have been bringing thoroughly vaccinated, groomed, and behavior-tested animals into hospitals, hospices, and assisted living homes to give seniors a chance to pet and play with them. The residents get to have some therapeutic physical contact and a fun activity to break up their day. More recently, some resident homes have even begun letting animals live in the home full time. The Stanton Health Center in Stanton, Nebraska, a residential nursing home, has had dogs for its Alzheimer wing and now has an aviary and cats that live in the center's common area.
"The animals help patients keep their mind off their problems," says Jean S. Uehl, the center's director of nurses. "The love the patients get from the animals is unconditional." One particular stroke patient was withdrawn and rarely smiled, until she began to play with the resident cat. The patient and the cat became closely bonded to each other, and when the cat had kittens, "they became like the patient's babies," according to Uehl. The kittens played and slept on a tray on the resident's wheelchair and slept in a chair near her bed whenever they could. The kittens brought the resident out of her shell and she began to talk and smile. "The kittens in particular get all the residents' attention," says Uehl. "Everyone always wants to know where they're at and what they're doing." When there are kittens in the building, a number of residents stay busy all day, following them, playing with them, and keeping an eye on them.
Finding that furry friend
If there are older people in your life that you think might benefit from having a pet at home, be sure to talk to them before you pick one out. Make sure that they want the responsibility of a new pet, as well as the noise and the messes that may come along with it. Talk to them about whether they feel capable of feeding, watering, grooming, exercising, and cleaning up after an animal. If they decide they're willing to accept that responsibility, take your elderly friend or family member out with you to the humane society or the breeder to pick out a new furry friend. They may fall in love with a dog or cat that might never have caught your eye.
Finally, before you encourage an older person to adopt a pet, consider whether you could take care of the animal if its owner is no longer able. Often, if seniors reach the point where they have to leave their homes and move into assisted-living facilities, they also have to give up their pets. The number of nursing homes and other types of housing for the elderly that will accept animals is growing, but the vast majority still don't allow pets. Seniors can plan ahead and find a pet-friendly nursing facility, just in case they need to use it someday. They may also want to consider planning for their pet in their estate.
Pets and the elderly have a lot to give to each other. Research and experience has shown that animals and older people can share their time and affection, and ultimately, full and happy lives. Though pets can't replace human relationships for seniors, they can certainly augment them, and they can fill an older person's life with years of constant, unconditional love.
Verlia Caldwell, Pres.
Visit us at http://www.icareforyouhomecare.com if you need home care in Charlotte, N.C..
I Care For You Home Care, L.L.C.
1(800) 383-0520
Scientists have noticed the same thing, and they've started to explore the complex way animals affect human emotions and physiology. The resulting studies have shown that owning and handling animals significantly benefits health, and not just for the young. In fact, pets may help elderly owners live longer, healthier, and more enjoyable lives.
A study published in the Journal of the American Geriatrics Society in May of 1999 demonstrated that independently living seniors that have pets tend to have better physical health and mental wellbeing than those that don't. They're more active, cope better with stress, and have better overall health. A 1997 study showed that elderly pet owners had significantly lower blood pressure overall than their contemporaries without pets. In fact, an experimental residential home for the elderly called the Eden Alternative, which is filled with over 100 birds, dogs, and cats and has an outside environment with rabbits and chickens, has experienced a 15 percent lower mortality rate than traditional nursing homes over the past five years.
How do they do it?
There are a number of explanations for exactly how pets accomplish all these health benefits. First of all, pets need walking, feeding, grooming, fresh water, and fresh kitty litter, and they encourage lots of playing and petting. All of these activities require some action from owners. Even if it's just getting up to let a dog out a few times a day or brushing a cat, any activity can benefit the cardiovascular system and help keep joints limber and flexible. Consistently performing this kind of minor exercise can keep pet owners able to carry out the normal activities of daily living. Pets may also aid seniors simply by providing some physical contact. Studies have shown that when people pet animals, their blood pressure, heart rate, and temperature decrease.
Many benefits of pet ownership are less tangible, though. Pets are an excellent source of companionship, for example. They can act as a support system for older people who don't have any family or close friends nearby to act as a support system. The JAGS study showed that people with pets were better able to remain emotionally stable during crises than those without. Pets can also work as a buffer against social isolation. Often the elderly have trouble leaving home, so they don't have a chance to see many people. Pets give them a chance to interact. This can help combat depression, one of the most common medical problems facing seniors today. The responsibility of caring for an animal may also give the elderly a sense of purpose, a reason to get up in the morning. Pets also help seniors stick to regular routines of getting up in the morning, buying groceries, and going outside, which help motivate them to eat and sleep regularly and well.
Pets in residence
Many nursing homes have taken this information to heart. For years, organizations like Pets on Wheels and Therapy Dogs International have been bringing thoroughly vaccinated, groomed, and behavior-tested animals into hospitals, hospices, and assisted living homes to give seniors a chance to pet and play with them. The residents get to have some therapeutic physical contact and a fun activity to break up their day. More recently, some resident homes have even begun letting animals live in the home full time. The Stanton Health Center in Stanton, Nebraska, a residential nursing home, has had dogs for its Alzheimer wing and now has an aviary and cats that live in the center's common area.
"The animals help patients keep their mind off their problems," says Jean S. Uehl, the center's director of nurses. "The love the patients get from the animals is unconditional." One particular stroke patient was withdrawn and rarely smiled, until she began to play with the resident cat. The patient and the cat became closely bonded to each other, and when the cat had kittens, "they became like the patient's babies," according to Uehl. The kittens played and slept on a tray on the resident's wheelchair and slept in a chair near her bed whenever they could. The kittens brought the resident out of her shell and she began to talk and smile. "The kittens in particular get all the residents' attention," says Uehl. "Everyone always wants to know where they're at and what they're doing." When there are kittens in the building, a number of residents stay busy all day, following them, playing with them, and keeping an eye on them.
Finding that furry friend
If there are older people in your life that you think might benefit from having a pet at home, be sure to talk to them before you pick one out. Make sure that they want the responsibility of a new pet, as well as the noise and the messes that may come along with it. Talk to them about whether they feel capable of feeding, watering, grooming, exercising, and cleaning up after an animal. If they decide they're willing to accept that responsibility, take your elderly friend or family member out with you to the humane society or the breeder to pick out a new furry friend. They may fall in love with a dog or cat that might never have caught your eye.
Finally, before you encourage an older person to adopt a pet, consider whether you could take care of the animal if its owner is no longer able. Often, if seniors reach the point where they have to leave their homes and move into assisted-living facilities, they also have to give up their pets. The number of nursing homes and other types of housing for the elderly that will accept animals is growing, but the vast majority still don't allow pets. Seniors can plan ahead and find a pet-friendly nursing facility, just in case they need to use it someday. They may also want to consider planning for their pet in their estate.
Pets and the elderly have a lot to give to each other. Research and experience has shown that animals and older people can share their time and affection, and ultimately, full and happy lives. Though pets can't replace human relationships for seniors, they can certainly augment them, and they can fill an older person's life with years of constant, unconditional love.
Verlia Caldwell, Pres.
Visit us at http://www.icareforyouhomecare.com if you need home care in Charlotte, N.C..
I Care For You Home Care, L.L.C.
1(800) 383-0520
Thursday, March 11, 2010
Long Distance Caring
by Emily Carton
It is not uncommon for families to be separated by great distances. But what happens when one or both parents reach a stage in their lives where they appear to be frail and vulnerable? What can you do to keep from living with an enormous amount of guilt and worry or feeling that to help means sacrificing your own life?
This article will offer a few suggestions as starting points for gaining control of the situation.
Begin by having a thorough assessment of your parent's situation. You need to make sure that what you hear long distance from your parent and about your parent matches the reality of the situation. Everyone has different perceptions about how one should live and when one's safety is at risk. A dirty or cluttered house may not mean a parent can no longer live by himself, only that he needs help in caring for his home. It may mean he is willing to live with lower standards in order to remain at home. If you are uncertain about the situation and potential risks, consider an assessment by an outside professional who can offer a more objective evaluation.
A careful evaluation means taking a close look at the physical, emotional, and social well being of the older person to determine what her needs are. For example: Is your parent able to prepare her own meals? Does she still have friends and a social life? Are her medical needs being met? Is she managing her own medication. How safe is her living situation? Is she still able to manage finances? What is her state of health? What long term plans need to be made?
Once you understand the issues, a care plan can be put in place. Are there people or agencies available to him that can provide him with home delivered meals? Are there senior centers where he can go? Does he have an informal network of people, who can look in on him or telephone him? Does he have funds to pay for services he might need? Is there a friend or a professional who could be an emergency contact? Is relocating to a different environment the best option for him?
Clearly, there may be a great deal of emotional turmoil, guilt, and concern in regards to an aging parent. It is important to remember that if your parent is still able to articulate what she wants, and a physician determines she still has the capacity to make her own decisions, then it is her decision as to where and how she lives. Just as a parent needs to let go of adult children to live their own lives, a child needs to give his parent space as well. Unless your parent wishes to move or receive more assistance, she has every right to refuse, even if family and friends think she is making a mistake. All you can do is insure that she is making an informed decision and share your concern with her.
If you feel that your parent is not capable of making an informed decision, then contact his physician for an assessment of his cognitive abilities. This poses different questions about safety and the ability to care for oneself. Yet, even in cases of dementia, there still might be resources available to help keep your parent at home. To do this, engage a geriatric social worker to assist you in making up a care plan and obtaining the necessary resources. If this is not possible due to a parent's extreme incapacity or limited resources, a social worker can also help you to either relocate him to a safer environment or assist in relocation to a facility closer to you.
Without fully assessing your parent's situation no one can offer specific options. Find a professional who can fully evaluate the situation and provide a series of options for your parent. Prior to your next visit to your parent, you may wish to locate a physician if your parent does not already have an ongoing relationship with one. You can also contact a social service agency or a private care manager to meet with you and your parent. If there are legal matters you may need an attorney. By trying to locate services prior to your next visit, you will save yourself days of searching and waiting for appointments.
There are no simple answers or solutions. Each person's situation is different. Each child has a different relationship with her parent, and this may also determine the level of your involvement. You need to think about your parent's needs and your own needs as well. You cannot force services upon a parent who is capable of making decisions and willing to live with some level of risk in order to remain at home. However, if your parent is no longer capable, then you need to act. Even if you notice only a small decline, it is not too early to know what resources are available and who might be able to help. You don't need to do it all yourself. Elicit the help of family members and friends, and, if appropriate, find a professional who knows the resources and can help you through the maze of decision making. You do not have to face this alone.
Verlia Caldwell, Pres.
Visit us at http://www.icareforyouhomecare.com if you need home care in Charlotte, N.C..
I Care For You Home Care, L.L.C.
1(800) 383-0520
It is not uncommon for families to be separated by great distances. But what happens when one or both parents reach a stage in their lives where they appear to be frail and vulnerable? What can you do to keep from living with an enormous amount of guilt and worry or feeling that to help means sacrificing your own life?
This article will offer a few suggestions as starting points for gaining control of the situation.
Begin by having a thorough assessment of your parent's situation. You need to make sure that what you hear long distance from your parent and about your parent matches the reality of the situation. Everyone has different perceptions about how one should live and when one's safety is at risk. A dirty or cluttered house may not mean a parent can no longer live by himself, only that he needs help in caring for his home. It may mean he is willing to live with lower standards in order to remain at home. If you are uncertain about the situation and potential risks, consider an assessment by an outside professional who can offer a more objective evaluation.
A careful evaluation means taking a close look at the physical, emotional, and social well being of the older person to determine what her needs are. For example: Is your parent able to prepare her own meals? Does she still have friends and a social life? Are her medical needs being met? Is she managing her own medication. How safe is her living situation? Is she still able to manage finances? What is her state of health? What long term plans need to be made?
Once you understand the issues, a care plan can be put in place. Are there people or agencies available to him that can provide him with home delivered meals? Are there senior centers where he can go? Does he have an informal network of people, who can look in on him or telephone him? Does he have funds to pay for services he might need? Is there a friend or a professional who could be an emergency contact? Is relocating to a different environment the best option for him?
Clearly, there may be a great deal of emotional turmoil, guilt, and concern in regards to an aging parent. It is important to remember that if your parent is still able to articulate what she wants, and a physician determines she still has the capacity to make her own decisions, then it is her decision as to where and how she lives. Just as a parent needs to let go of adult children to live their own lives, a child needs to give his parent space as well. Unless your parent wishes to move or receive more assistance, she has every right to refuse, even if family and friends think she is making a mistake. All you can do is insure that she is making an informed decision and share your concern with her.
If you feel that your parent is not capable of making an informed decision, then contact his physician for an assessment of his cognitive abilities. This poses different questions about safety and the ability to care for oneself. Yet, even in cases of dementia, there still might be resources available to help keep your parent at home. To do this, engage a geriatric social worker to assist you in making up a care plan and obtaining the necessary resources. If this is not possible due to a parent's extreme incapacity or limited resources, a social worker can also help you to either relocate him to a safer environment or assist in relocation to a facility closer to you.
Without fully assessing your parent's situation no one can offer specific options. Find a professional who can fully evaluate the situation and provide a series of options for your parent. Prior to your next visit to your parent, you may wish to locate a physician if your parent does not already have an ongoing relationship with one. You can also contact a social service agency or a private care manager to meet with you and your parent. If there are legal matters you may need an attorney. By trying to locate services prior to your next visit, you will save yourself days of searching and waiting for appointments.
There are no simple answers or solutions. Each person's situation is different. Each child has a different relationship with her parent, and this may also determine the level of your involvement. You need to think about your parent's needs and your own needs as well. You cannot force services upon a parent who is capable of making decisions and willing to live with some level of risk in order to remain at home. However, if your parent is no longer capable, then you need to act. Even if you notice only a small decline, it is not too early to know what resources are available and who might be able to help. You don't need to do it all yourself. Elicit the help of family members and friends, and, if appropriate, find a professional who knows the resources and can help you through the maze of decision making. You do not have to face this alone.
Verlia Caldwell, Pres.
Visit us at http://www.icareforyouhomecare.com if you need home care in Charlotte, N.C..
I Care For You Home Care, L.L.C.
1(800) 383-0520
Tuesday, March 2, 2010
Elderly patients who survive ICU stay have high rate of death in following years
March 2, 2010
An analysis of Medicare data indicates that elderly patients who are hospitalized in an intensive care unit (ICU) and survive to be discharged from the hospital have a high rate of death in the following three years, and that, in particular, patients who receive mechanical ventilation have a substantially increased rate of death compared with both hospital and general population controls in the first several months after hospital discharge, according to a study in the March 3 issue of JAMA.
Although there has been a decrease over time in the risk of in-hospital death for patients who receive intensive care in the United States, little is known about subsequent outcomes for those discharged alive. "Patients older than 65 years now make up more than half of all ICU admissions," the authors write. "Information is needed to understand the patterns of mortality, morbidity, and health care resource use in the months and years that follow critical illness to allow for better targeting of follow-up care."
Hannah Wunsch, M.D., M.Sc., of Columbia University Medical Center and NewYork-Presbyterian Hospital/Columbia, New York, and colleagues examined the 3-year outcomes and health care resource use of ICU survivors, and identified subgroups of patients and periods in which patients are at highest risk of death, using a 5 percent sample of Medicare beneficiaries older than 65 years. A random half of all patients were selected who received intensive care and survived to hospital discharge in 2003 with 3-year follow-up through 2006. From the other half of the sample, 2 matched control groups were generated: hospitalized patients who survived to discharge (hospital controls) and the general population (general controls), individually matched on age, sex, race, and whether they had surgery (for hospital controls).
In the data analyzed for the study, 35,308 ICU patients survived to hospital discharge. The ICU survivors had a higher 3-year mortality (39.5 percent) than hospital controls (34.5 percent) and general controls (14.9 percent). The ICU survivors who did not receive mechanical ventilation had minimal increased risk compared with hospital controls (3-year mortality, 38.3 percent vs. 34.6 percent).
"However, mortality for those who received mechanical ventilation was substantially higher than for the corresponding hospital controls (3-year mortality: 57.6 percent vs. 32.8 percent, respectively). This difference was primarily due to mortality during the first 2 quarters following hospital discharge (6-month mortality: 30.1 percent for ICU survivors vs. 9.6 percent for hospital controls)," the authors write.
Discharge to a skilled care facility for ICU survivors (33.0 percent) and hospital controls (26.4 percent) also was associated with high 6-month mortality (24.1 percent for ICU survivors and hospital controls discharged to a skilled care facility vs. 7.5 percent for ICU survivors and hospital controls discharged home).
"The magnitude of the postdischarge use of skilled care facilities for both ICU survivors and hospital controls and the high long-term mortality for all of these patients call into question whether discharge to skilled care facilities is merely a marker for higher severity of illness with appropriate delivery of care. These patients could have been discharged prematurely from acute care hospitals, and needed a higher level of care than they received. It also is possible that these patients could have had better outcomes if discharged home, but were not able to be sent there due to lack of sufficient support from family or friends to act as caregivers. These findings highlight the need for a much more detailed understanding of the long-term care needs of these patients," the authors conclude.
More information: JAMA. 2010;303[9]:849-856.
Provided by JAMA and Archives Journals (news : web)
Verlia Caldwell, Pres.
Visit us at http://www.icareforyouhomecare.com if you need home care in Charlotte, N.C..
I Care For You Home Care, L.L.C.
1(800) 383-0520
An analysis of Medicare data indicates that elderly patients who are hospitalized in an intensive care unit (ICU) and survive to be discharged from the hospital have a high rate of death in the following three years, and that, in particular, patients who receive mechanical ventilation have a substantially increased rate of death compared with both hospital and general population controls in the first several months after hospital discharge, according to a study in the March 3 issue of JAMA.
Although there has been a decrease over time in the risk of in-hospital death for patients who receive intensive care in the United States, little is known about subsequent outcomes for those discharged alive. "Patients older than 65 years now make up more than half of all ICU admissions," the authors write. "Information is needed to understand the patterns of mortality, morbidity, and health care resource use in the months and years that follow critical illness to allow for better targeting of follow-up care."
Hannah Wunsch, M.D., M.Sc., of Columbia University Medical Center and NewYork-Presbyterian Hospital/Columbia, New York, and colleagues examined the 3-year outcomes and health care resource use of ICU survivors, and identified subgroups of patients and periods in which patients are at highest risk of death, using a 5 percent sample of Medicare beneficiaries older than 65 years. A random half of all patients were selected who received intensive care and survived to hospital discharge in 2003 with 3-year follow-up through 2006. From the other half of the sample, 2 matched control groups were generated: hospitalized patients who survived to discharge (hospital controls) and the general population (general controls), individually matched on age, sex, race, and whether they had surgery (for hospital controls).
In the data analyzed for the study, 35,308 ICU patients survived to hospital discharge. The ICU survivors had a higher 3-year mortality (39.5 percent) than hospital controls (34.5 percent) and general controls (14.9 percent). The ICU survivors who did not receive mechanical ventilation had minimal increased risk compared with hospital controls (3-year mortality, 38.3 percent vs. 34.6 percent).
"However, mortality for those who received mechanical ventilation was substantially higher than for the corresponding hospital controls (3-year mortality: 57.6 percent vs. 32.8 percent, respectively). This difference was primarily due to mortality during the first 2 quarters following hospital discharge (6-month mortality: 30.1 percent for ICU survivors vs. 9.6 percent for hospital controls)," the authors write.
Discharge to a skilled care facility for ICU survivors (33.0 percent) and hospital controls (26.4 percent) also was associated with high 6-month mortality (24.1 percent for ICU survivors and hospital controls discharged to a skilled care facility vs. 7.5 percent for ICU survivors and hospital controls discharged home).
"The magnitude of the postdischarge use of skilled care facilities for both ICU survivors and hospital controls and the high long-term mortality for all of these patients call into question whether discharge to skilled care facilities is merely a marker for higher severity of illness with appropriate delivery of care. These patients could have been discharged prematurely from acute care hospitals, and needed a higher level of care than they received. It also is possible that these patients could have had better outcomes if discharged home, but were not able to be sent there due to lack of sufficient support from family or friends to act as caregivers. These findings highlight the need for a much more detailed understanding of the long-term care needs of these patients," the authors conclude.
More information: JAMA. 2010;303[9]:849-856.
Provided by JAMA and Archives Journals (news : web)
Verlia Caldwell, Pres.
Visit us at http://www.icareforyouhomecare.com if you need home care in Charlotte, N.C..
I Care For You Home Care, L.L.C.
1(800) 383-0520
Wednesday, February 24, 2010
Vision problems linked to higher dementia risk
By Amy Norton
NEW YORK (Reuters Health) - Elderly adults with poor vision, particularly untreated vision problems, may have a higher risk of developing dementia than those with better vision, a new study suggests.
Researchers found that among 625 older Americans with initially normal cognition, those who said they had poor vision even with corrective lenses were more likely to develop dementia over the next 8.5 years.
During the study period, 168 participants developed Alzheimer's disease or other forms of dementia. Of those men and women, less than 10 percent had rated their vision as "excellent" at the start of the study. That compared with almost 31 percent of participants who maintained normal brain function over the study period.
On the other hand, about one-quarter of the study participants who went on to develop dementia had rated their vision as "fair" or "poor" at the outset, versus 11 percent of those whose memory and thinking remained intact.
When the researchers looked at the effects of treatment, they found that the highest odds of dementia were among people with poor vision left untreated. The risk was lower when they received some form of eye care.
The findings, published in the American Journal of Epidemiology, do not prove that vision problems contribute to dementia -- or that eye care can help slow cognitive decline.
But they do suggest that could be the case, according to lead researcher Dr. Mary A.M. Rogers, a research assistant professor of internal medicine at the University of Michigan in Ann Arbor.
It has long been known that there is an association between dementia and vision disorders, Rogers noted in an interview with Reuters Health. But in practice those problems are often detected and treated after a dementia diagnosis.
The current findings, Rogers said, show that vision problems may precede a dementia diagnosis by years.
It's not clear why eye disorders and poor vision would contribute to dementia. One possibility, Rogers explained, is the fact that limited vision could keep older adults from being active -- whether it's getting out and walking, reading, doing crosswords or socializing. All of those things, she noted, have been linked to a decreased risk of dementia in older adults.
The findings are based on 625 older U.S. adults who were part of a larger health study begun in 1992.
Overall, Rogers' team found, study participants who reported "very good" or "excellent" vision were 63 percent less likely to develop dementia over the next 8.5 years than those with poor vision.
The researchers then looked at the combined effects of vision problems with or without treatment on the risk of Alzheimer's disease specifically. Compared with people who had good vision and at least one visit to an ophthalmologist during the study period, those with poor vision and no visits were more than nine times as likely to be diagnosed with Alzheimer's.
By comparison, among study participants who had poor vision and at least one ophthalmologist visit, the risk of Alzheimer's was not significantly increased.
Similarly, men and women with poor vision who had received no eye procedures, such as cataract removal, had a five-fold increase in the risk of Alzheimer's. That risk was elevated by 2.5 times among people with poor vision who had received such procedures.
According to Rogers, the findings imply that older adults with vision problems should seek treatment -- if for no other reason than to improve their sight.
"If you have poor vision, don't sit on it. Go and see your doctor," she said. It's best, Rogers added, to see an ophthalmologist, a medical doctor who can diagnose the range of problems common in elderly adults, such as cataract, glaucoma, macular degeneration and diabetes-related retinopathy.
More studies are needed to replicate the current findings and determine whether vision problems are an actual risk factor for dementia, according to Rogers. With the number of people with Alzheimer's disease increasing, she said, it is becoming even more important to "take a look at the things we can do to either delay or prevent dementia."
SOURCE: American Journal of Epidemiology, online February 11, 2010.
Verlia Caldwell, Pres.
Visit us at http://www.icareforyouhomecare.com if you need home care in Charlotte, N.C..
I Care For You Home Care, L.L.C.
1(800) 383-0520
NEW YORK (Reuters Health) - Elderly adults with poor vision, particularly untreated vision problems, may have a higher risk of developing dementia than those with better vision, a new study suggests.
Researchers found that among 625 older Americans with initially normal cognition, those who said they had poor vision even with corrective lenses were more likely to develop dementia over the next 8.5 years.
During the study period, 168 participants developed Alzheimer's disease or other forms of dementia. Of those men and women, less than 10 percent had rated their vision as "excellent" at the start of the study. That compared with almost 31 percent of participants who maintained normal brain function over the study period.
On the other hand, about one-quarter of the study participants who went on to develop dementia had rated their vision as "fair" or "poor" at the outset, versus 11 percent of those whose memory and thinking remained intact.
When the researchers looked at the effects of treatment, they found that the highest odds of dementia were among people with poor vision left untreated. The risk was lower when they received some form of eye care.
The findings, published in the American Journal of Epidemiology, do not prove that vision problems contribute to dementia -- or that eye care can help slow cognitive decline.
But they do suggest that could be the case, according to lead researcher Dr. Mary A.M. Rogers, a research assistant professor of internal medicine at the University of Michigan in Ann Arbor.
It has long been known that there is an association between dementia and vision disorders, Rogers noted in an interview with Reuters Health. But in practice those problems are often detected and treated after a dementia diagnosis.
The current findings, Rogers said, show that vision problems may precede a dementia diagnosis by years.
It's not clear why eye disorders and poor vision would contribute to dementia. One possibility, Rogers explained, is the fact that limited vision could keep older adults from being active -- whether it's getting out and walking, reading, doing crosswords or socializing. All of those things, she noted, have been linked to a decreased risk of dementia in older adults.
The findings are based on 625 older U.S. adults who were part of a larger health study begun in 1992.
Overall, Rogers' team found, study participants who reported "very good" or "excellent" vision were 63 percent less likely to develop dementia over the next 8.5 years than those with poor vision.
The researchers then looked at the combined effects of vision problems with or without treatment on the risk of Alzheimer's disease specifically. Compared with people who had good vision and at least one visit to an ophthalmologist during the study period, those with poor vision and no visits were more than nine times as likely to be diagnosed with Alzheimer's.
By comparison, among study participants who had poor vision and at least one ophthalmologist visit, the risk of Alzheimer's was not significantly increased.
Similarly, men and women with poor vision who had received no eye procedures, such as cataract removal, had a five-fold increase in the risk of Alzheimer's. That risk was elevated by 2.5 times among people with poor vision who had received such procedures.
According to Rogers, the findings imply that older adults with vision problems should seek treatment -- if for no other reason than to improve their sight.
"If you have poor vision, don't sit on it. Go and see your doctor," she said. It's best, Rogers added, to see an ophthalmologist, a medical doctor who can diagnose the range of problems common in elderly adults, such as cataract, glaucoma, macular degeneration and diabetes-related retinopathy.
More studies are needed to replicate the current findings and determine whether vision problems are an actual risk factor for dementia, according to Rogers. With the number of people with Alzheimer's disease increasing, she said, it is becoming even more important to "take a look at the things we can do to either delay or prevent dementia."
SOURCE: American Journal of Epidemiology, online February 11, 2010.
Verlia Caldwell, Pres.
Visit us at http://www.icareforyouhomecare.com if you need home care in Charlotte, N.C..
I Care For You Home Care, L.L.C.
1(800) 383-0520
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